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Multiple thyroid nodules

I have had several us over the years, each showing something different.  Recently I had an us that showed 4 nodules all about 1cm.  The doctor states since they are so small I shouldnt be concerned.  How can I not be concerned when I have 4 nodules?  Is it unreasonable at this point to consider having the thyroid removed?  Or should I just deal with it and realize that i have a multi nodular goitar... Any advise would be great.  I have moved to a new city and am having a very hard tme finding a thorough doctor.  
10 Responses
158939 tn?1274918797
It is estimated that 20% of 20 year olds have thyroid nodules; 30% of 30 year olds, and on it goes according to age (so if you make it to 100 you're pretty sure you have nodules).

Of those, 90-95% of thyroid nodules are BENIGN (non cancerous).

What would be helpful is if you could get your hands on any test results you've had (especially ultrasounds, uptake scans, CT scans, etc.) and list what the results were here.  There are a few things that make nodules a bit more suspicious than others.

Here's a great web site that can help:  http://www.endocrineweb.com/thyroid.html

Meanwhile, are they causing you any problems?  Why were they found?

A bit more information can help us to help you.

Utahmomma
536139 tn?1273189552
I am 42 yrs old.  After my annual physical, my blood test came back with a TSH level of 0.085.  I was sent to an Endo.  I had a RAI Thyroid Scan.  It came back normal.  Then I had a thyroid sonogram, which revealed a multinodular goiter.  I asked about the fine needle biopsy, and the endo said no.  My nodules were sub-centimeters.  The endo says I am HYPER, yet her report (she interpreted it - not a radiologist) said I have Hashi's thyroiditis.  I am only on Inderal for the mild hyper symptoms I have.  I guess size is key in getting a FNB?  Blood tests are as follows:

TSH, 3rd generation  0.01 Low
T4 Free  1.7 Normal (although I see the range is 0.8-1.8; is this high normal?)
T3 Free   462 High (scale says 230-420)
Thyroid Peroxidase AB (this is TPO, correct?)  <10 normal
Thyroglobulin  AB <20.0  Normal

Should I be doing something else other than taking 10mg Inderal  three times a day?  Is it okay NOT to have a FNB?  Only thing that is scheduled is repeat blood tests in July, and follow-up sonon in one year, or as clinically necessary.

Sorry to jump on this thread, but I can't help being nervous about all of this.  I had very few symptoms of hyper (never cold, slight breathlessness during exercise), but the Inderal "masked" that completely.  The only thing that's making me ill seems to be the diagnosis!!!!   Thanks!
536139 tn?1273189552
Or if 898 is out there, please comment :)
Avatar universal
Many small nodules are often observed during the thyroiditis (thyroid inflammation). Non-elevated TPO and TG antibodies may eliminate Hashimoto’s condition. During the early stage or reoccurrence of silent or sub-acute thyroiditis, the inflammation ruins the follicles which causes many small cysts and leakage of hormones into the bloodstream.[the later causes the thyroid hormones to be elevated with hyperthyroidism , and low TSH].
The iodine uptake is reduced during the hashimoto’s condition and very low in sub-acute or silent thyroiditis.  
Other cases of spontaneous hyper-  condition happens if the person has longstanding multinodular non-toxic thyroid ; latter in life these nodules are “gaining” autonomy [a.k.a hot nodules] and responsible for hyper condition.
536139 tn?1273189552
Thank you so much for ressponding.  I've been refreshing for an hour, lol!  So, if I understand correctly, if my next blood test is the same regarding TPO an TG, it's not Hashi's?  Is it possible that this is just thyroiditis?  Am I getting the right treatment (no FNA, only Inderal and repeat blood tests next month)?  The RAI Scan was normal, as it was 31% on a scale of 6 to 35% being "Normal Range", and found no masses.  Just that darn ultra sound with the "multiple sub-cm nodules throughout the thyroid bed", and one on each lobe measuring .075 (under 1 cm).  THANKS SO MUCH FOR ANY ADDITIONAL COMMENT!!!!
Avatar universal
If elevated TPO and TG AB's are present, then sooner or later the person may develop the Hashi condition; these AB 's are often elevated BEFORE the beginning of the disease. Beacuase they are less then 1cm, by the today's trend, they not need to be biopsed.
From the article:
The normal range for the RAI-U is 8% to 35% although the ranges are different in various geographic locations, relative to dietary iodine concentrations. Some researchers say that with the increased iodine content of the American diet, the RAI-U may no longer show clear abnormalities.

. [E.Moore, RAI scan, 2000]
Patients with hyperthyroidism and multinodular goiters may have normal to increased iodine uptake. The nodules can be very small, often only a few millimeters in size, or the nodules can be larger, perhaps several cm each. {My thyroid *******}
Patients with toxic nodular goiter have NONE of the autoimmune manifestations or circulating antibodies observed in patients with Graves' disease. {Merk manual}
Based of all of this I just have read, in my opinion, most likely  these 2 nodules began to produce too much hormones causing the hyperthyroidism.
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